Innovative Pro-Poor Service Delivery Model to Improve Quality and Access to Health Care Services across India
GVK Emergency Management and Research Institute A Non-profit organization Integrated Emergency Response Service Integrated Emergency Response Service addressing the challenge of poor access addressing the challenge of poor access to emergency support to emergency support
Launched on 15 th Aug, ‘05 in Hyderabad and expanded to 9 other States Jammu & Kashmir Himachal Pradesh Arunachal Punjab Pradesh Uttarakhand Haryana Delhi Sikkim Rajasthan Uttar Assam Nagaland Pradesh Bihar Meghalaya Manipur a Jharkhand West Mizoram Gujarat Madhya Pradesh Bengal Tripura h r a g s i Orissa t t a h Maharashtra C Andhra Pradesh Goa Karnataka Tamil Nadu Plans to reach national coverage serving Kerala more than 1 billion people in two years
Successfully Implemented by GVK EMRI in PPP Framework • 100% of Capital expenditure and Operational expenses by Government (Public) • GVK EMRI provides and funds Leadership, Innovation (Infrastructure, Process), Collaborations, Research and Training, Knowledge transfer and Quality assurance • Mahindra Satyam provides IT solutions as technology partner • GVK EMRI manages and leverages government resources for better outcomes to serve poor
Situation • 75,000 emergencies occur per day (30 M p.a.) • 80% are at the bottom of the pyramid • 80% deaths occur in hospitals in the first hour • 4 M deaths p.a. (Cardiac, Road Accidents, Maternal, Suicidal attempts, Neonatal / Infant / Pediatric, Diabetic related, etc) due to absence of 4As : – A ccess to a universal toll-free number – A vailability of Life Saving Ambulance to reach quickly nearest and appropriate health facility – A ffectionate Care by trained paramedics (Compassion, Ability, Resourcefulness & Energy) – A ffordability by every citizen independent of income, religion and community (mostly user fee services)
Programme Vision • To respond to 30 million emergencies and save 1 million lives annually using innovative delivery model of emergency response services (for Medical, Police and Fire emergencies) under PPP (Public Private Partnership) structure that provides emergency and pre ‐ hospital care free of charge to the patient through a mix of government and private funding • To deliver services at global standards through Leadership, Innovation, Technology and Research & Training Technology Leadership Innovation R & T
Integrated Emergency Management Integrated Emergency Management Infrastructure of the Programme Infrastructure of the Programme Three digit toll-free number – Accessible from Land lines and mobile phones Modern, spacious and open Emergency Response Centers GIS / GPS to locate emergency victim / ambulance and information about health care facility locations and capacities Designed and developed cost effective ambulances to provide quality care for Indian emergencies with facilities for rescuing and balancing patient care with public safety and patients relatives comfort Trained personnel for providing pre-hospital care
Key Components of the Programme Key Components of the Programme Detailed process building • Developed detailed process understanding and well defined responsibilities through out the organization • Maintained all information related to emergency in Patient Care Records (PCRs) • Patient information is shared with the hospital on arrival • 48 hour follow up with the patients admitted to hospital Follow up Sense Care Reach after 48 hrs
Key Components of the Programme .. Key Components of the Programme .. Innovative use of Technology COMPUTER SERVER ROOM Public Switching Telephone Network (PSTN) Caller in distress Telephone DB SCCS, CCT & Voice ERS DB GIS DB Dial 108 Logger Nortel Switch Dispatch Officers (DO) Communication Officers (CO) E R C Transfer CO Supervisor DO Supervisor ERCP Conference EMT in Ambulance Ambulance FI ELD Base Location Victim Shifted to Hospital Victim Location (Scene) CCT : Communication Control Toolkit; SCCS : Symposium Call Centre Server; ERCP : Emergency Response Center Physician; EMT : Emergency Medical Technician
Key Components of the Programme Key Components of the Programme Quality pre-hospital care • Emergency Medical Technician (EMT) in the ambulance is trained not only to provide pre-hospital care but also to handle emergency situations • EMT gets support over phone from qualified medical practitioner called ERCP (Emergency Response Centre Physician) located at the ERC • ERCPs are in the ERC round the clock to provide support to EMT and to people at emergency scene until ambulance arrives
Collaboration for transfer of Knowledge and Technology know-how, Best practices, Research & Training Carnegie Mellon University, Stanford University, Geomed Research USA USA American Assoc of American Physicians Academy for Of Indian Origin Singapore Health Emergency (AAPI) Services Medicine in India Shock Trauma Public Health Center, Foundation of India USA
Impact • One Center for 40 M population Size • 433 M population covered in 10 States (increased reach of health care in rural , hilly and tribal areas) –Rural area population : 277 M (64% ); Tribal area population : 41 M (10% ) • Trained 30,000 people (19,623 EMTs & Pilots and 9,290 Doctors and others) • 11,200 + emergencies handled per day (6.2 Million cumulative) • 2,710 Ambulances - 4.5 trips a day • 16,300 + GVK EMRI Associates Speed • Went live in less than 4 months from signing MoU • 91% calls taken in first ring • < 15 minutes (urban) and < 25 minutes (rural) Ambulances reached • Pregnancy related - 31% , Vehicular Trauma – 18% , Acute Abdomen – 12% Cardiac – 4% , Type of Em ergencies and Lives saved Respiratory – 4% , Suicidal – 3% , Animal Bites 3% • 300+ lives were saved per day (199,000 + till now) and 10,900 victims per day received timely, high-quality pre-hospital care • Cost per ambulance trip $ 12 to $15 USA Costs • A historic landmark in health care delivery system Qualitative Outcom es • Built more trust in the health system as a whole • Increased institutional deliveries and reduced maternal mortalities by 20 – 25% • A model for replication across the Country in any state
Impact - Doing More with Less for More
Impact - Doing More with Less for More
Award-winning GVK EMRI Microsoft Computer World eIndia 2008 Received prestigious awards from The Computer World, Microsoft, IT User – CNBC, 9-1-1 of USA, Ahmedabad Management Association, eIndia, CSI Nihilent and HEAL Foundation
To Conclude • Reduction in poverty and increase in Quality of Life can be achieved by Caring, Valuing and Respecting Life with Humaneness, Humility and Commitment to serve people • This Joy of Giving back to society increases Dopamine (Satisfaction), Oxytocin (Attachment) and Frontal Cortex Activity (Morals)
THANK YOU Subodh Satyawadi Chief Operating Officer, GVK EMRI 108 – Emergency Response Service, Gujarat www.emri.in
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